Dilatation of radicles of rectal veins within the anal canal is called
piles.

The medical term for piles is hemorrhoids.

Compared to arteries veins are weak due to thin walls and hence any backpressure in the veins can
make them tortuous.

There are three rectal veins namely superior, middle and inferior rectal veins.

Any obstructions or increase of pressure in these veins can predispose
piles.

Depending upon the situation there are two types of piles:

External piles

Internal piles

External piles:

This type of piles is seen outside the anal opening and is covered by skin. It is black or brown in
color. This type of piles is very painful due to rich nerve supply in this
area.

Internal piles:

It is inside the anal canal and internal to the anal orifice. It is covered by mucous membrane and
is red or purple in color. These piles are painless.

Sometimes internal and external piles occur in same
individual.

Factors responsible for piles:

This is a familial disease.

Piles is seen only in animals maintain an erect posture. This is due to congestion in the rectal
veins due to the effect of gravity.

It is common in individuals having chronic constipation. Those who have a habit of visiting the
toilet due to frequent urge for stool may develop piles in future.

Piles are common in those who take excess of chicken, prawns, spicy food etc. Those who take
vegetables and fibrous food are rarely affected.

Some women will get piles during pregnancy due to compression of rectal veins by the
uterus.

Cancerous lesions in the rectum can obstruct blood flow and result in
piles.

Signs and symptoms of piles:

Pain: Pain is common in external piles which will be worse while straining at
stool.

Bleeding: Bleeding comes in splashes while pressing
for stool. Bleeding may be profuse in some cases. Protruding mass: In external piles the swelling
can be felt around the anal orifice. In case of internal piles initially it cannot be felt. When
the disease progresses the piles protrude during stool and will go inside automatically.

When the condition becomes worse the protruded piles will not go back in to the anus. In some cases
there will be discharge of mucus with itching around the anal orifice.

Complications of piles:

Infection: The infection can spread to deep veins resulting in septicemia.

Fibrosis: Here the piles become fibrosed with hardening of anal orifice.

Thrombosis: Here the blood inside the piles will form clots and can obstruct blood
flow.

Gangrene: Here the tissues in the piles and nearby skin die due to lack of blood
supply.

Suppuration: When the piles suppurate it can produce abscess with discharge of pus.

Treatment of piles:

Initially it is treated on the basis of symptoms. Constipation should
be treated.

If there is anemia iron should be given.

Homoeopathic medicines can give good results.

If medicinal treatment is not giving any result the following can be
tried:

The thrombosis external pile
is excised under local anesthesia.

Sclerosant
(sklĕ-ro´sant) injection therapy can reduce the size of piles.

Rubber band ligation around the neck of piles is useful in some cases.